Hello again. Most of you know me.
Long story short - I’ve been trying to optimize my testosterone and well being in many different ways not wanting to commit to TRT, but seems soon I’ll not have a choice. The thing that troubles me more is I’ve run a seamen analysis last week and its not perfect. The doctor said I’m still fertile, but I have lowered percentage of motile sperm and its classified as asthenozoospermia. This is the analysis:
Why I would need TRT? Well I have ALL symptoms of Low T and the following blood work(will post only most relevant of it):
|TSH||S||1.73||µIU/ml||0.27 - 4.20||ECLIA|
|LH||S||2.65||IU/L||1.70 - 8.60||ECLIA|
|FSH||S||1.13||IU/L||1.5 - 12.40||ECLIA|
|Prolactin||S||352.6||mIU/L||84.80 - 318||ECLIA|
|Estradiol||S||16.04||ng/L||7.63 - 42.60||ECLIA|
|Total Testosterone||S||14.14||nmol/l||9.90 - 27.80||ECLIA|
|Free Testosteron||S||9.1||ng/l||8.30 - 40.10||RIA|
|DHEA-s||S||8.63||µmol/l||4.34 - 12.20||ECLIA|
|SHBG||S||32.09||nmol/l||18.30 - 54.10||ECLIA|
25-OH-Vitamin D S 41.35 ng/ml > 30 ECLIA
I’ve been discovered last summer to have thyroid node, non-cancerous and this winter empty sella syndrom on the pituitary after doing NMRi. After this blood work on 23-rd April I did a consultation with Defy. They advised me to start taking cabergoline 0.125mg 2 times a week and clomid 12.5mg EOD. I could not handle how I felt from the clomid and stopped it only 10 days after. However, it has started to raise my numbers.
I took little blood tests after:
07.05.2019 - after 10 days taking caber and clomid
|Prolactin||S||283.5||mIU/L||84.80 - 318||ECLIA|
|Estradiol||S||21.92||ng/L||7.63 - 42.60||ECLIA|
|Total Testosterone||S||18.15||nmol/l||9.90 - 27.80||ECLIA|
On this date basically I stopped the clomid.
|Free T3 (fT3)||S||2.88||ng/l||2 - 4.40||ECLIA|
|LH||S||3.09||IU/L||1.70 - 8.60||ECLIA|
|Prolactin||S||288.9||mIU/L||84.80 - 318||ECLIA|
|Total Testosterone||S||21.25||nmol/l||9.90 - 27.80||ECLIA|
|Estradiol||S||21.45||ng/L||7,63 - 42,60||ECLIA|
|SHBG||S||41.84||nmol/l||18,30 - 54,10||ECLIA|
|Cortisol (morning)||S||480.9||nmol/l||133 - 537||ECLIA|
|Reverse T3||S||325||pg/ml||90 - 215||RIA|
|Free Testosteron||S||16||ng/L||7 - 22,70||EIA|
Seems the testosterone has increased. Unfortunately it turns out to be from the clomid. This is the highest T value I’ve ever measured(around 600 in the USA units) and I’ve been doing regular tests since spring of 2017.
Yesterday I run this tests:
|TSH||S||1.74||µIU/ml||0.27 - 4.20||ECLIA|
|Free Т4 (fT4)||S||14.66||ng/l||9.30 - 17||ECLIA|
|Free T3 (fT3)||S||2.79||ng/l||2 - 4.40||ECLIA|
|Reverse T3||S||pg/ml||90 - 215||RIA|
|ТАТ (Tg Ат)||S||10||IU/ml||0 - 115||ECLIA|
|A-TPO (MAT)||S||5||IU/ml||0 - 34||ECLIA|
|Total Testosterone||S||18.06||nmol/l||9.90 - 27.80||ECLIA|
|Free Testosteron||S||ng/L||7 - 22.70||EIA|
|SHBG||S||nmol/l||18.30 - 54.10||ECLIA|
|LH||S||4.54||IU/L||1.70 - 8.60||ECLIA|
|FSH||S||1.39||IU/L||1.5 - 12.40||ECLIA|
|Prolactin||S||265.4||mIU/L||84.80 - 318||ECLIA|
|Estradiol||S||27.07||ng/L||7.63 - 42.60||ECLIA|
|DHEA-s||S||9.01||µmol/l||4.34 - 12.20||ECLIA|
|Cortisol (morning)||S||363.6||nmol/l||133 - 537||ECLIA|
|Cortisol (afternoon)||S||324.6||nmol/l||68.20 - 327||ECLIA|
|PSA||S||0.511||ng/ml||0.010 - 1.400||ECLIA|
|hemoglobin||EB||153||g/l||140 - 180||SLS|
|hematocrit||EB||0.44||l/l||0.40 - 0.53||calc|
|Total Cholesterol||S||4.58||mmol/l||3.5 - 5.20||PHOT|
|LDL-Cholesterol||S||2.92||mmol/l||0 - 3.35||PHOT|
|Glucose||S||5.41||mmol/l||2.80 - 6.10||HK|
|AST||S||17||IU/l||0 - 40||IFCC|
|ALT||S||16||IU/l||0 - 41||IFCC|
|Magnesium||S||0.76||mmol/l||0.66 - 1.07||PHOT|
|Iron||S||18.02||µmol/l||7.20 - 27.70|
|Vitamin В12||S||416.9||pmol/l||145 - 569||ECLIA|
|25-OH-Vitamin D||S||70||ng/ml||20-80/ opt. values >40||ECLIA|
Seems my total T has dropped to 520 in the USA units. Free T and SHBG are not ready yet, but I do not expect surprises there. And I expect the total to go to 400s after a month or 2 where it normally revolves. What are my options when I cannot handle clomid? I guess HCG Mono or TRT. The thing is I WANT TO KEEP MY FERTILITY. I plan to try how I will feel on nolvadex, but I do not put much hope on that and I know it is not recommended for prolonged usage. I can also try restart protocol. The strange thing is my LH has increased, but total T dropped? Is it possible because I started metformin 10 days ago?
I do not have kids yet and I definetely want to have in the future, but Im not there yet. You know its not exactly something you do just because you thing time may be right.
I am arranging now consultation with one of the best hormone optimization doctors worldwide and I’m pretty sure he will advise my that optimizing my testosterone levels will make me feel much better. I guess he may also optimize my thyroid later.
What do you think about my optimization/fertility concern?